Why contraception rule is no gimmick

It is unfortunate that a federal regulation ensuring that Americans with private health insurance have access to contraception without the burden of a co-payment has unleashed a political maelstrom, including claims that President Barack Obama is waging a “war on religion.” Reducing sensitive health care policy questions to a metaphorical crusade might make for good sound bites, but it distorts public understanding of an important issue. Let’s revisit the facts obscured by this heated debate.

One important provision of the Affordable Care Act is a requirement that group health plans and health insurers completely cover various preventive services — including vaccinations and screening and counseling services. Congress adopted this since it leads to greater use of those services. This, in turn, results in better health and saves money — because avoidable conditions are prevented and treatable conditions detected earlier.

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Insurance coverage of contraceptives is common in the United States. Twenty-eight states have laws that require health insurers cover contraceptives. Studies cited in the regulation found that more than 80 percent of insurers and large employers already do this. Several court decisions have held that an employer’s failure to provide it is illegal sex discrimination.

Nonetheless, some religious groups, notably the Catholic Church, teach that contraception is wrong. These religious groups employ thousands of Americans and provide health benefits. So the federal agencies implementing the Affordable Care Act tried to reach an accommodation between the public health objective of increasing access to preventive services and the goal of protecting religious freedom.

The Obama administration’s first response was to exclude “religious employers” from the contraceptive coverage requirement, defining the term to mean churches and their integrated auxiliaries, and associations and religious orders that inculcate religious values and primarily serve and employ people who share their beliefs.

This exception, however, didn’t cover religious hospitals, universities or charities, some of which also objected. But these institutions often employ women who do not hold to their employer’s religious beliefs. Excusing all these employers from compliance would deprive their workers of access to contraceptive services. Many religious leaders and heads of institutions objected to this tailoring.